Coronary Artery Disease Detected by Multislice Computed Tomography in Patients After Long-Term Cure of Cushing's Syndrome

• Published in: The journal of clinical endocrinology and metabolism 2013-03, Vol.98 (3), p.1093-1099
• Main Authors: Barahona, María-José, Resmini, Eugenia, Viladés, David, Pons-Lladó, Guillem, Leta, Rubén, Puig, Teresa, Webb, Susan M
• Format: Article
• Language: English
• Subjects: Adrenals. Adrenal axis. Renin-angiotensin system (diseases); Adult; Age Distribution; Biological and medical sciences; Calcinosis - diagnostic imaging; Calcinosis - epidemiology; Cardiac Imaging Techniques; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - epidemiology; Cushing Syndrome - epidemiology; Cushing Syndrome - therapy; Endocrinopathies; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Humans; Male; Medical sciences; Middle Aged; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Pituitary ACTH Hypersecretion - epidemiology; Pituitary ACTH Hypersecretion - therapy; Prevalence; Remission Induction; Risk Factors; Sex Distribution; Tomography, X-Ray Computed; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vertebrates: endocrinology
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.2012-3547

Objective: Increased cardiovascular risk persists in Cushing's syndrome (CS), despite remission of hypercortisolism. The aim of this study was to evaluate the prevalence of coronary artery disease in patients after long-term cure of CS. Methods: Cardiac multidetector computed tomography was performed in 29 cured CS patients (5 men, 21 of pituitary origin, 50 ± 13 y, mean time of “cure” 11 ± 6 y), using 64-slice Toshiba Aquilion systems (Toshiba Medical Systems, Otawara, Japan). Noncontrast acquisitions were performed to detect coronary calcifications and, after injection of an iodinated contrast agent, for coronary angiography. Calcium was quantified by the Agatston score. Cured patients were compared with 48 gender-matched and age-matched healthy controls. Results: Cured CS patients had more hypertension and smoked less than controls (P < .05). The prevalence of coronary calcifications (31% vs 21%) and noncalcified plaques (20% vs 7.8%) tended to be higher in cured CS patients than controls. When only women were analyzed (24 CS and 34 controls), more abnormal multidetector computed tomography results were found (42% vs 18%; P < .05). When patients and controls in the youngest tertile (